囊动脉瘤的内血管和微手术管理:一个多中心的审查
Joseph Reidy1, Kenneth Faulder2,3, Keryn Davidson2
1Department of Neurosurgery, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia. josephdreidy@gmail.com.
Neurosurgical review
|June 24, 2023
概括
囊动脉瘤 (BA) 是一个具有挑战性的脑血管病变. 血管内治疗对急性治疗有希望,与手术相比,它具有较少的侵入性和较低的发病率,尽管结果相似.
科学领域:
- 神经外科 神经外科
- 干预性神经放射学 干预性神经放射学
- 脑血管疾病 脑血管疾病
背景情况:
- 囊动脉瘤 (BA) 是一种罕见的,高风险的脑血管病变,占内动脉瘤的1%.
- 它们有缺陷的血管壁和宽的部会带来重大治疗挑战,导致高的复发和死亡率,特别是在下关节出血后.
研究的目的:
- 评估和比较内血管和微手术对内囊泡动脉瘤管理的结果.
- 在现实世界,多中心环境中评估不同治疗方式的安全性和有效性.
主要方法:
- 在2010年1月至2022年10月期间,在两个三级医院接受治疗的21名已确认患有泡动脉瘤的患者的回顾性审查.
- 系统的成像数据库搜索"泡"和选的操作报告治疗细节.
- 分析的临床结果包括排放处置,动脉瘤排除和术后并发症.
主要成果:
- 76%的病例采用了内血管治疗 (16/21),而19%的病例采用了手术管理 (剪切或包裹和剪切) (4/21).
- 内血管方法显示,手术期间破裂和发病率较低.
- 在内血管和外科手术组之间,死亡率和成功的出院率是可比的.
结论:
- 囊动脉瘤带来复杂的管理挑战,具有显著的发病率和死亡率.
- 内血管治疗是急性管理的有希望的,不那么侵入性的选择,与减少手术内并发症有关.
- 仔细考虑抗血栓治疗和可能需要进一步的干预措施对于最佳的患者结果至关重要.
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